共查询到20条相似文献,搜索用时 15 毫秒
1.
Junichi Mazaki Kenji Katsumata Tetsuo Ishizaki Noritoshi Fukushima Ryutaro Udo Tomoya Tago Kenta Kasahara Hiroshi Kuwabara Masanobu Enomoto Yuichi Nagakawa Akihiko Tsuchida 《Medicine》2022,101(27)
Anastomotic leakage (AL) after colorectal surgery is a serious complication. This study aimed to evaluate the effectiveness of the EEA™ circular stapler, a new triple-row circular stapler (TCS), relative to a conventional, double-row circular stapler (DCS).A total of 285 patients who underwent anastomosis with the double stapling technique at the Tokyo Medical University Hospital between 2017 and 2021 were included in this nonrandomized clinical trial with historical controls using a propensity score (PS) analysis. The primary endpoint was the risk of AL.We performed a 1:2 PS matching analysis. Before case matching, AL occurred in 15 (7.4%) and 2 (2.4%) patients in the DCS and TCS groups, respectively, with no significant difference (P = .17). After case matching, AL occurred in 13 patients (11.6%) and 1 patient (1.8%) in the DCS and TCS groups, respectively, revealing a significant difference (P = .04). Cox models were created by applying PS to adjust for group differences via regression adjustment. Odds ratios for AL in the DCS group versus the TCS group were 0.31 (95% confidence interval [CI]: 0.07–1.38) in the entire cohort, 0.15 (95% CI: 0.02–0.64) in the regression adjustment cohort, and 0.14 (95% CI: 0.02–1.09) in the 1:2 PS-matched cohort.PS analysis of clinical data suggested that the use of TCS contributes to a reduced risk of AL after colorectal anastomosis CTwith the double stapling technique. 相似文献
2.
Predictors and prognostic significance of atrial fibrillation developed during dobutamine stress echocardiography: A propensity score‐matched comparison 下载免费PDF全文
Yuba Acharya MD Sahil Agrawal MD Junu Bhattarai MD Vlad Cotarlan MD Jamshid Shirani MD 《Echocardiography (Mount Kisco, N.Y.)》2017,34(3):429-435
3.
《British journal of haematology》2018,180(6):799-807
Post‐partum haemorrhage (PPH) remains the major cause of maternal death worldwide, with the overwhelming majority of bleeding deaths occurring in low income countries. These bleeding deaths occur due to a complex network of biological and socioeconomic factors, including changes to haemostasis and fibrinolysis during pregnancy. Tranexamic acid (TxA) has been shown to reduce death in bleeding trauma patients safely and is effective in reducing bleeding in surgical patients, however its role in PPH has been less well established. We discuss the impact of the recently published World Maternal Antifibrinolytic (WOMAN) trial, which demonstrated a significant reduction in bleeding deaths (Risk ratio 0·81) in women with PPH who received intravenous TxA compared to those receiving placebo. There were no increases in post‐partum thrombotic rates in mothers or breast‐fed babies. This trial has shown that intravenous TxA can be used safely and effectively to treat PPH, and should be implemented widely to reduce death due to PPH. However, for the full benefit of TxA to be fully realised in resource‐constrained settings, the effectiveness of oral or topical administration and/or pre‐emptive dosing need to be investigated. 相似文献
4.
Comparison of endoscopic and open resection of sinonasal squamous cell carcinoma: a propensity score–matched analysis of 652 patients 下载免费PDF全文
Suat Kılıç BA Sarah S. Kılıç MA Soly Baredes MD FACS Richard Chan Woo Park MD FACS Omar Mahmoud MD PhD Jeffrey D. Suh MD FACS Stacey T. Gray MD FACS Jean Anderson Eloy MD FACS 《International forum of allergy & rhinology》2018,8(3):421-434
Background
The use of endoscopic resection as an alternative to open surgery for sinonasal malignancies has increased in the past 20 years.Methods
The National Cancer Database was queried for cases of sinonasal squamous cell carcinoma (SNSCC) without cervical or distant metastases that were treated surgically between 2010 and 2014. They were split into 2 groups based on surgical approach: open or endoscopic. Demographics, facility and insurance type, stage, tumor characteristics, postoperative treatment, 30‐day readmission rate, 30‐ and 90‐day mortality, and overall survival (OS) were compared between the 2 groups. Cox proportional hazard analysis was performed. Propensity score matching (PSM) was used to mimic a randomized, controlled trial.Results
A total of 1,483 patients were identified: 353 (23.8%) received endoscopic and 1130 (76.2%) received open surgery. Age, gender, race, geographic region, tumor size, surgical margins, postoperative chemoradiation, and 30‐day readmissions did not vary significantly between the 2 groups. Open surgery was more common in academic centers (62.8% vs 54.2%; p = 0.004), less common for tumors of the ethmoid and sphenoid sinus (p < 0.0001), less common for stage IVB tumors, and associated with longer hospital stay (mean, 4.67 days vs 2.50 days; p < 0.0001). Five‐year OS (5Y‐OS) was not significantly different between the 2 approaches (p = 0.953; open: 5Y‐OS, 56.5%; 95% confidence interval, 51.3% to 61.6%; endoscopic: 5Y‐OS, 46.0%; 95% confidence interval, 33.2% to 58.8%). In the PSM cohort of 652 patients, there was also no significant difference in OS (p = 0.850).Conclusion
Endoscopic surgery is an effective alternative to open surgery, even after accounting for confounding factors that may favor its use over the open approach. It is also associated with a shorter hospital stay.5.
Prevention of pancreatic fistula using polyethylene glycolic acid mesh reinforcement around pancreatojejunostomy: the propensity score‐matched analysis 下载免费PDF全文
Jae Seung Kang Youngmin Han Hongbeom Kim Wooil Kwon Sun‐Whe Kim Jin‐Young Jang 《Journal of hepato-biliary-pancreatic sciences》2017,24(3):169-175
6.
Minimally invasive liver resection for hepatocellular carcinoma of patients with liver damage B: A propensity score‐based analysis 下载免费PDF全文
Takehiro Noda Hidetoshi Eguchi Yoshifumi Iwagami Daisaku Yamada Tadafumi Asaoka Kunihito Gotoh Koichi Kawamoto Shogo Kobayashi Yasuji Hashimoto Yutaka Takeda Masahiro Tanemura Koji Umeshita Yuichiro Doki Masaki Mori 《Hepatology research》2018,48(7):539-548
7.
8.
Hepatic arterial infusion chemotherapy with cisplatin and sorafenib in hepatocellular carcinoma patients unresponsive to transarterial chemoembolization: A propensity score‐based weighting 下载免费PDF全文
Masaaki Kondo Manabu Morimoto Tomohiro Ishii Akito Nozaki Hiroyuki Fukuda Kazushi Numata Satoshi Kobayashi Shinichi Ohkawa Hisashi Hidaka Takahide Nakazawa Akitaka Shibuya Chiaki Okuse Michihiro Suzuki Kentaro Sakamaki Satoshi Morita Shin Maeda Katsuaki Tanaka 《Journal of digestive diseases》2015,16(3):143-151
9.
10.
Impact of the branched‐chain amino acid to tyrosine ratio and branched‐chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis 下载免费PDF全文
Toshifumi Tada Takashi Kumada Hidenori Toyoda Seiki Kiriyama Makoto Tanikawa Yasuhiro Hisanaga Akira Kanamori Shusuke Kitabatake Tsuyoki Yama 《Journal of gastroenterology and hepatology》2015,30(9):1412-1419
11.
The effect of dialysis type on left atrial functions in patients with end‐stage renal failure: A propensity score‐matched analysis 下载免费PDF全文
Uğur Aksu MD Derya Aksu MD Oktay Gulcu MD Kamuran Kalkan MD Selim Topcu MD Enbiya Aksakal MD Emrah Aksakal MD Serdar Sevimli PhD Ibrahim Halil Tanboga MD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(3):308-313
12.
Comparison of late adverse events after endoscopic sphincterotomy versus endoscopic papillary large balloon dilation for common bile duct stones: A propensity score‐based cohort analysis 下载免费PDF全文
Akinori Maruta Takuji Iwashita Shinya Uemura Kensaku Yoshida Keisuke Iwata Tsuyoshi Mukai Shinpei Doi Ichiro Yasuda Kenji Imai Masahito Shimizu 《Digestive endoscopy》2018,30(4):493-500
13.
To examine whether the association between blood transfusion and suicide attempt exists.Utilizing the national insurance database from Taiwan and propensity score matching analysis, the incidence of suicide attempt in a cohort with blood transfusion versus controls was compared.The key finding is that higher incidence of suicide attempt in blood transfusion than control group (with an adjusted hazard ratio of 1.79 with 95% confidence interval, 1.72–1.88) after adjusted for the covariates.Patients receiving blood transfusion are an increased risk of subsequent suicide attempt. 相似文献
14.
Seventeen adults received the antifibrinolytic drug tranexamic acid during cardiac surgery utilizing extracorporeal circulation (ECC). In 8 patients, drug administration began prior to skin incision (pre-ECC); infusions commenced after ECC and protamine administration in another 9 patients (post-ECC). Compared with the post-ECC group, the pre-ECC group exhibited less bleeding via mediastinal drains (420 vs. 655 mL/12 h median, P = 0.024), decreased frequency of the presence (greater than or equal to 10 micrograms/mL) of fibrin split products (P less than 0.05), and greater platelet dense granule content of adenosine diphosphate after surgery (15.47 vs. 4.05 nmoles/mg protein median, P = 0.021). Follow-up in vitro study of tranexamic acid inhibition of plasmin-induced platelet activation utilizing normal human platelet rich plasma and porcine plasmin revealed a 13-fold lower concentration of tranexamic acid for 50% inhibition when plasmin was preincubated with the drug (1.2 micrograms/mL, 95% CI = 1.13-1.60 micrograms/mL) compared to when platelet rich plasma was preincubated with the drug (16 micrograms/mL, 95% CI = 7.3-99. micrograms/mL). Plasmin inactivated with tranexamic acid retained its ability to inhibit thrombin-induced platelet activation, thus suggesting that tranexamic acid inhibits plasmin's catalytic activity and not its binding to platelets. Both clot lysis and platelet dysfunction may contribute to bleeding after ECC. Tranexamic acid blocks plasmin-induced partial platelet activation during ECC, thus preserving platelet function and promoting hemostasis after ECC. 相似文献
15.
Shu He Hans Johnsson Michal Zabczyk Kjell Hultenby Honglie Cao Margareta Blombck 《British journal of haematology》2013,160(6):806-816
To assess whether Haemocomplettan® (fibrinogen concentrate) or Fibrogammin® (Factor XIII concentrate) can be used to manage bleeding complications of antithrombotic treatment, we examined a normal plasma pool spiked with AR‐H067637 (thrombin inhibitor) or rivaroxaban (activated factor X‐inhibitor), to which one of the concentrates was added. Fibrin network permeability (Ks), images of Scanning Electron Microscopy (SEM) and Clot Lysis Time (CLT) were examined. Both inhibitors increased the Ks levels, which could be fully or partly reversed by Haemocomplettan® or Fibrogammin® respectively. However, these modified clots with tightened network remained non‐resistant to fibrinolysis, shown as unaffected CLT. Tranexamic acid at a very low concentration (0·4 mg/ml) aided the two concentrates to stabilize the clots, where the prolongation of CLT was more pronounced for a lower dose than a higher dose of Haemocomplettan® while Fibrogammin® brought the greatest delay to CLT out of all additions. These observations were partly supported by SEM images, displaying alterations of fibrin fibre arrangement known to influence fibirinolysis. The in vitro data suggest that Haemocomplettan® or Fibrogammin® given in combination with a mini dose of tranexamic acid may slow down the natural clearance of fibrin clot by plasmin and thus prevent patients from haemorrhagic complications during antithrombotic therapy. 相似文献
16.
Effect of antishock trousers on the trauma score: a prospective analysis in the urban setting 总被引:2,自引:0,他引:2
W H Bickell P E Pepe C H Wyatt W R Dedo D J Applebaum C T Black K L Mattox 《Annals of emergency medicine》1985,14(3):218-222
This study was designed to determine the effect of military antishock trousers (MAST) use on the presenting emergency center trauma score (TS) in an urban prehospital setting. Sixty-eight patients were assigned randomly to study and control groups in a prospective investigation of the use of MAST on injured patients with hypotension. Thirty-two control patients, whose mean initial systolic BP was 59 +/- 32 mm Hg, and 36 MAST-treated patients, whose mean initial BP was 55 +/- 31 mm Hg, were found to be well matched for age; sex; type and location of injuries; initial field TS; response, field management, and transport times; and the total amount of intravenous crystalloid infused. Our results demonstrated no significant difference between the control and MAST-treated groups in the presenting emergency department TS (9.8 +/- 6.6 vs 10.6 +/- 5.9). These data conflict with the widely accepted belief that MAST will always enhance conventional support for improving the prehospital condition of injured patients with significant hypotension. 相似文献
17.
《Clinical cardiology》2017,40(11):1156-1162
Background
Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR).Hypothesis
TAVR is associated with better in‐hospital outcomes compared with SAVR in patients with advanced kidney disease.Methods
We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We included patients with chronic kidney disease stages IV and V and end‐stage renal disease as advanced kidney disease patients. We excluded patients with acute kidney injury on admission and patients on dialysis.Results
After propensity matching, 2485 patients were included in each group. The primary outcome of in‐hospital mortality (12.9% vs 6.2%; P < 0.01) was higher with SAVR as compared with TAVR. Patients who underwent SAVR reported higher acute kidney injury (50.3% vs 33%; P < 0.01) and dialysis requirements (26.8% vs 20.1%; P < 0.01). Other secondary outcomes including blood transfusion, atrial fibrillation, iatrogenic cardiac complications, pericardial complications, perioperative stroke, perioperative infections, and postoperative shock were more common with SAVR. With SAVR, the length of hospitalization and hospitalization costs were significantly higher; however, permanent pacemaker placement was more common with TAVR compared with SAVR.Conclusions
In patients with advanced kidney disease, SAVR was associated with higher mortality and higher periprocedural complications, as compared with TAVR. Thus, benefits of TAVR could be extended in patients with advanced kidney disease who cannot undergo surgery.18.
19.